Provider Demographics
NPI:1376657007
Name:BURDULIS, SHARON C (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:C
Last Name:BURDULIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:CAHALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 GROVE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3156
Mailing Address - Country:US
Mailing Address - Phone:508-528-5392
Mailing Address - Fax:508-541-2420
Practice Address - Street 1:229 E MAIN ST
Practice Address - Street 2:COMMUNITY PEDIATRICS
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2807
Practice Address - Country:US
Practice Address - Phone:508-634-7333
Practice Address - Fax:508-482-5436
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156080208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3180581Medicaid
MA3180581Medicaid
A23719Medicare ID - Type Unspecified